| NPI | 1023215472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENE NELSON Nursing Supervisor 719-383-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: CO 04413092) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-08-22 |